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Prescribing Skills Assessment Prescribing Skills Assessment Training Workshop PSA Question item styles Prescribing, Prescription Review, Planning Management.

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Presentation on theme: "Prescribing Skills Assessment Prescribing Skills Assessment Training Workshop PSA Question item styles Prescribing, Prescription Review, Planning Management."— Presentation transcript:

1 Prescribing Skills Assessment Prescribing Skills Assessment Training Workshop PSA Question item styles Prescribing, Prescription Review, Planning Management and Data Interpretation John Mucklow Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

2 Prescribing Skills Assessment StationDescriptionMarksComments 1Prescribing 1101 question item of 10 marks 2Prescribing 2101 question item of 10 marks 3Prescription Review 182 question items of 4 marks each 4Planning Management82 question items of 4 marks each 5Communicating Information63 question items of 2 marks each 6Drug Calculation Skills84 question items of 2 marks each 7Prescribing 3101 question item of 10 marks 8Prescribing 4101 question item of 10 marks 9Prescription Review 282 question items of 4 marks each 10Adverse Drug Reactions84 question items of 2 marks each 11Drug Monitoring84 question items of 2 marks each 12Data Interpretation63 question items of 2 marks each TOTAL MARKS100 Prescribing Skills Assessment – Format Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

3 Prescribing Skills Assessment PRESCRIBING Competencies Reasoning and judgement Deciding on the most appropriate prescription (drug, dose, route and frequency) to write, based on the clinical circumstances and supplementary information. Measurable action Writing a safe, effective and legal prescription for a single medicine, using the documentation provided to tackle a specific indication highlighted by the question. Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

4 Prescribing Skills Assessment PRESCRIBING This question type will present: a clinical scenario a request to write a prescription for a single appropriate medicine or fluid on one of a variety of prescription charts Typical scenarios will involve the treatment of: acute conditions (e.g. acute asthma) chronic conditions (e.g. reflux oesophagitis) important symptoms (e.g. pain) Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

5 Prescribing Skills Assessment PRESCRIBING The candidate will have to exercise judgement when deciding between different drugs, formulations, routes, doses and dose intervals Typical medicines will include those that are high-risk (e.g. insulin) or in common use (e.g. antibiotics), and IV fluids Prescriptions must be legible, unambiguous and complete approved name written in upper case appropriate form and route correct dose appropriately written without abbreviation necessary details and instructions, signed Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

6 Prescribing Skills Assessment PRESCRIBING Items may involve prescriptions written into a variety of prescription forms, including: hospital once-only regular medicines fluid prescription charts general practice (FP10) forms Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

7 Prescribing Skills Assessment PRESCRIBING Good Prescribing question items should: be based on a clinical scenario that might be faced by a Foundation doctor expect actions that might reasonably be expected of a Foundation doctor avoid using over-elaborate clinical scenarios – restrict content to what is required to answer question Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

8 Prescribing Skills Assessment PRESCRIBING Case presentation A [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Try to adhere to this general layout but there is room for flexibility] Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

9 Prescribing Skills Assessment PRESCRIBING On examination Temperature xx.x°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O 2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are……. Investigations Na + xxx mmol/L (137–144), K + xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc. ECG shows ……… CXR shows ……… [Provide sufficient information to enable the candidate to make a sound judgement about the need for and choice of treatment] Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

10 Prescribing Skills Assessment PRESCRIBING Good Prescribing question items should: state clearly the symptom or problem to be addressed by the prescription within the ‘Prescribing Request’ box require only one prescription to be written Prescribing request Write a prescription for ONE drug that will help to [treat/alleviate/prevent] [symptom or problem]. Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

11 Prescribing Skills Assessment Prescribing Item Case presentation A [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examination Temperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O 2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are ……. Investigations Na + xxx mmol/L (137–144), K + xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc. ECG shows ……… CXR shows ……… [Authors should provide sufficient information from the clinical examination and investigations to enable the candidate to make a sound judgement about the need for and choice of treatment] Prescribing request Write a prescription for ONE drug that will help to [treat/alleviate/prevent] [symptom or problem]. (use the hospital ‘once-only medicines’ prescription chart provided) Please paste any picture or other illustration that supports the clinical case into this box PWS000 ID This question item is worth 10 marks You may use the BNF at any time ONCE ONLY MEDICINES Date Tim e Medicine (Approved name)DoseRoutePrescriber – sign + print Tim e given Given by Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

12 Prescribing Skills Assessment Case presentation A [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examination Temperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O 2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are ……. Investigations Na + xxx mmol/L (137–144), K + xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc. ECG shows ……… CXR shows ……… [Authors should provide sufficient information from the clinical examination and investigations to enable the candidate to make a sound judgement about the need for and choice of treatment] Prescribing request Write a prescription for ONE drug that will help to [treat/alleviate/prevent] [symptom or problem]. (use the hospital ‘regular medicines’ prescription chart provided) Please paste any picture or other illustration that supports the clinical case into this box PWS000 ID This question item is worth 10 marks Date Time Drug (Approved name) 6 8 DoseRoute 12 Prescriber – sign + printStart date NotesPharmacy 22 You may use the BNF at any time Prescribing Item Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

13 Prescribing Skills Assessment Case presentation A [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examination Temperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O 2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are ……. Investigations Na + xxx mmol/L (137–144), K + xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc. ECG shows ……… CXR shows ……… Prescribing request Write a prescription for ONE intravenous fluid that would be most appropriate for the patient at this point. (use the hospital fluid prescription chart provided) Please paste any picture or other illustration that supports the clinical case into this box PWS000 ID This question item is worth 10 marks INFUSION THERAPY Date Start time Infusion solutionMedicine added Prescriber’s signature Given by Type/strengthVolumeRouteRateDurationApproved nameDose You may use the BNF at any time Prescribing Item Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

14 Prescribing Skills Assessment Case presentation A [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examination Temperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O 2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are ……. Investigations Na + xxx mmol/L (137–144), K + xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc. ECG shows ……… CXR shows ……… [Authors should provide sufficient information from the clinical examination and investigations to enable the candidate to make a sound judgement about the need for and choice of treatment] Prescribing request Write a prescription for ONE drug that will help to [treat/alleviate/prevent] [symptom or problem]. (use the general practice prescription form provided) Please paste any picture or other illustration that supports the clinical case into this box PWS000 ID This question item is worth 10 marks Pharmacy Stamp Please don’t stamp over age box Age 0yr 0mths D.o.B. 00/00/0000 Title, Forename, Surname & Address Patient Name Address Line 1 Address Line 2 Town Postcode Number of days’ treatment N.B. Ensure dose is stated Endorsements Drug name Dose Frequency Signature of Prescriber Signature Date 00/00/0000 For Dispenser No. of Prescns. on form Xxxxx Health Authority Dr Address Town Postcode Tel: FP10NC0105 You may use the BNF at any time Prescribing Item Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

15 Prescribing Skills Assessment PRESCRIBING Answer page Clinical scenarios seldom have only one correct answer Identify those answers that you believe to be optimal and those that are suboptimal but worthy of credit Enter these on the Answer page that follows the question template. Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

16 Prescribing Skills Assessment Marking guide for A and B. Candidates should be given 4 marks for an optimal answer that can’t be improved. They should get 3 marks for an answer that is good but is suboptimal on some grounds (e.g. cost-effectiveness, likely adherence). They should get 2 marks for an answer that is likely to provide benefit but is clearly suboptimal for more than one reason. They should get 1 mark for an answer that has some justification and deserves some credit. PWS000 ID This question item is worth 10 marks You may use the BNF at any time Answer Page C. Timing. Candidates will also be given 1 mark for correctly dating (and timing) the prescription D. Signature. Candidates will also be given 1 mark for signing the prescription A. Drug choice ScoreFeedback/justification B. Dose and route ScoreFeedback/justification Prescribing Item Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

17 Prescribing Skills Assessment PRESCRIBING Marking guide for A and B. Candidates should be given 4 marks for an optimal answer. They should get 3 marks for an answer that is good but is suboptimal on some grounds (e.g. cost-effectiveness, likely adherence). They should get 2 marks for an answer that is likely to provide benefit but is clearly suboptimal for more than one reason. They should get 1 mark for an answer that has some justification and deserves some credit. The mark achieved in A determines the maximum achievable mark in B. Candidates cannot compensate for a suboptimal choice of drug by correctly stating its dose and route. C. Timing. Candidates will also be given 1 mark for correctly dating (and timing) the prescription D. Signature. Candidates will also be given 1 mark for signing the prescription Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

18 Prescribing Skills Assessment Please use the British National Formulary, to which the candidates will have access throughout, as the ultimate arbiter of dose ranges, routes, indications, contra- indications, etc. Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

19 Prescribing Skills Assessment StationDescriptionMarksComments 1Prescribing 1101 question item of 10 marks 2Prescribing 2101 question item of 10 marks 3Prescription Review 182 question items of 4 marks each 4Planning Management82 question items of 4 marks each 5Communicating Information63 question items of 2 marks each 6Drug Calculation Skills84 question items of 2 marks each 7Prescribing 3101 question item of 10 marks 8Prescribing 4101 question item of 10 marks 9Prescription Review 282 question items of 4 marks each 10Adverse Drug Reactions84 question items of 2 marks each 11Drug Monitoring84 question items of 2 marks each 12Data Interpretation63 question items of 2 marks each TOTAL MARKS100 Prescribing Skills Assessment – Format Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

20 Prescribing Skills Assessment PRESCRIPTION REVIEW Competencies Reasoning and judgement Deciding which components of the current prescription list are inappropriate, unsafe or ineffective for a patient, based on their clinical circumstances Measurable action Identifying prescriptions (drugs, doses or routes) that are inappropriate, unsafe or ineffective from amongst the current list of prescribed medicines Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

21 Prescribing Skills Assessment PRESCRIPTION REVIEW This question type will present: a scenario that requires review of a current list of prescribed medicines Typically this question type will involve: interpreting the list of medicines in light of a clinical problem, spotting important drug interactions identifying obvious or serious dosing errors noting suboptimal prescriptions Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

22 Prescribing Skills Assessment PRESCRIPTION REVIEW The total list of medicines for each question item should range from 4–10 Some knowledge of common effects, adverse reactions and interactions of common medicines will be assumed Candidates should have time to consult the BNF for relevant information that might be considered beyond the core knowledge base of a minimally competent Foundation doctor Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

23 Prescribing Skills Assessment PRESCRIPTION REVIEW Good Prescription Review question items should: state clearly in each of two questions associated with each list the reason why between 1 and 3 items on the list of prescriptions need to be identified typically ask the candidate to identify medicines that contain dosing errors, or are causing symptoms, contra-indicated, likely to interact, etc. Question A Select the [ONE/TWO/THREE prescription/prescriptions] that [is/are] [contra-indicated/most likely to be a cause of/contains a serious dosing error/interact/, etc.]. (mark [it/them] with a tick in column A) Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

24 Prescribing Skills Assessment Prescribing Skills Assessment – Prescription Review Question Item Example Prescription Review Item REV000 ID This question item is worth 4 marks You may use the BNF at any time CURRENT PRESCRIPTIONS Drug name DoseRoute Freq. AB Drug 1xx mgIVdaily ☐☐ Drug 2xx mgORAL12-hrly ☐☐ Drug 3xx mg ☐☐ Drug 4xx mg ☐☐ Drug 5xx mg ☐☐ Drug 6xx mg ☐☐ Drug 7xx mg ☐☐ Drug 8xx mg ☐☐ Drug 9xx mg ☐☐ Drug 10xx mg ☐☐ Case presentation A [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom that might be used as the focus for one of the questions] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] His current regular medicines are listed (right). [Authors should try to adhere to this general layout but there is room for flexibility – the presentations should be fairly brief] Question A Select the [ONE/TWO/THREE prescription/prescriptions] that [is/are] [contra-indicated/most likely to be a cause of/contains a serious dosing error/interact/, etc.]. (mark [it/them] with a tick in column A) Question B Select the [ONE/TWO/THREE prescription/prescriptions] that [is/are] [contra-indicated/most likely to be a cause of/contains a serious dosing error/interact/, etc.]. (mark [it/them] with a tick in column B) Answer box Question AMarks per correct tick[1 or 2] Write a brief justification in this box Question BMarks per correct tick[1 or 2] Write a brief justification in this box Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

25 Prescribing Skills Assessment PRESCRIPTION REVIEW CURRENT PRESCRIPTIONS Drug nameDoseRouteFreq. AB Drug 1xx mgIVdaily ☐☐ Drug 2xx mgORAL12-hrly ☐☐ Drug 3xx mg ☐☐ Drug 4xx mg ☐☐ Drug 5xx mg ☐☐ Drug 6xx mg ☐☐ Drug 7xx mg ☐☐ Drug 8xx mg ☐☐ Drug 9xx mg ☐☐ Drug 10xx mg ☐☐ Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

26 Prescribing Skills Assessment PRESCRIPTION REVIEW Answer box Question AMarks per correct tick[1 or 2] Write a brief justification in this box Question BMarks per correct tick[1 or 2] Write a brief justification in this box Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

27 Prescribing Skills Assessment StationDescriptionMarksComments 1Prescribing 1101 question item of 10 marks 2Prescribing 2101 question item of 10 marks 3Prescription Review 182 question items of 4 marks each 4Planning Management82 question items of 4 marks each 5Communicating Information63 question items of 2 marks each 6Drug Calculation Skills84 question items of 2 marks each 7Prescribing 3101 question item of 10 marks 8Prescribing 4101 question item of 10 marks 9Prescription Review 282 question items of 4 marks each 10Adverse Drug Reactions84 question items of 2 marks each 11Drug Monitoring84 question items of 2 marks each 12Data Interpretation63 question items of 2 marks each TOTAL MARKS100 Prescribing Skills Assessment – Format Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

28 Prescribing Skills Assessment PLANNING MANAGEMENT Competencies Reasoning and judgement Deciding which combination of therapies would be most appropriate to manage a particular clinical situation Measurable action Selecting the most appropriate combination of treatment strategies based on individual patient circumstances Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

29 Prescribing Skills Assessment PLANNING MANAGEMENT This question type will present: a clinical scenario followed by a request to identify the important therapeutic strategies for initial management This will involve: selecting between options (e.g. medicines, fluids) that would be of real benefit and others that would be neutral or harmful The candidate will have to decide on: the two most appropriate prescriptions, based on symptoms, signs and investigations, from a list of five Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

30 Prescribing Skills Assessment PLANNING MANAGEMENT The treatment might be preventive, curative, symptomatic or palliative The question tests the ability to plan treatment appropriate to individual patients. Candidates should be aware of situations where it is inappropriate to prescribe and also of the role of non- drug therapies. Some of these scenarios may relate to the management of clinical toxicological emergencies The likely diagnosis (or differential diagnosis) will not necessarily be identified; planning management is sometimes necessary even when the diagnosis is not certain Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

31 Prescribing Skills Assessment PLANNING MANAGEMENT Good Planning Management question items should: be based on a list of 5 management options from which the candidate will be required to select the 2 most appropriate contain sufficient information to allow a competent candidate to select the 2 best options unambiguously contain 3 distracting options that, while plausible, are clearly less appropriate than the correct answers in relation to the clinical scenario Question Select the TWO most appropriate management options at this stage. (mark them with a tick) Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

32 Prescribing Skills Assessment Planning Management Item MAN000 ID This question item is worth 4 marks You may use the BNF at any time MANAGEMENT OPTIONS AOption A ☐ BOption B ☐ COption C ☐ DOption D ☐ EOption E ☐ Case presentation A [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examination Temperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O 2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are ……. Investigations Na + xxx mmol/L (137–144), K + xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc. ECG shows ……… CXR shows ……… [Authors should try to adhere to this general layout but there is room for flexibility – the presentations should contain sufficient information to allow candidates to select the 2 best options from the list you provide but should not be over-elaborate] Question Select the TWO most appropriate management options at this stage. (mark them with a tick) Answer box Option AJustification Write a brief justification in this box Option BJustification Write a brief justification in this box Option CJustification Option DJustification Option EJustification Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

33 Prescribing Skills Assessment PLANNING MANAGEMENT MANAGEMENT OPTIONS AOption A ☐ BOption B ☐ COption C ☐ DOption D ☐ EOption E ☐ List options in alphabetical order, starting with a lower case letter, unless option is a proper noun. Identify the 2 correct answers by placing a tick in the column on the right. Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

34 Prescribing Skills Assessment PLANNING MANAGEMENT Answer box Option AJustification Write a brief justification in this box Option BJustification Write a brief justification in this box Option CJustification Option DJustification Option EJustification Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

35 Prescribing Skills Assessment StationDescriptionMarksComments 1Prescribing 1101 question item of 10 marks 2Prescribing 2101 question item of 10 marks 3Prescription Review 182 question items of 4 marks each 4Planning Management82 question items of 4 marks each 5Communicating Information63 question items of 2 marks each 6Drug Calculation Skills84 question items of 2 marks each 7Prescribing 3101 question item of 10 marks 8Prescribing 4101 question item of 10 marks 9Prescription Review 282 question items of 4 marks each 10Adverse Drug Reactions84 question items of 2 marks each 11Drug Monitoring84 question items of 2 marks each 12Data Interpretation63 question items of 2 marks each TOTAL MARKS100 Prescribing Skills Assessment – Format Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

36 Prescribing Skills Assessment DATA INTERPRETATION Competencies Reasoning and judgement Deciding on the meaning of the results of investigations as they relate to decisions about ongoing drug therapy Measurable action Making an appropriate change to a prescription based on those data Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

37 Prescribing Skills Assessment DATA INTERPRETATION This question type will involve: interpreting data in the light of a clinical scenario deciding on the most appropriate course of action with regard to prescribing The correct course of action may involve: withdrawing a medicine reducing its dose no change increasing its dose prescribing a new medicine Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

38 Prescribing Skills Assessment DATA INTERPRETATION Good Data Interpretation question items should: be based on a clinical scenario where a treatment decision (e.g. choosing from a selection of treatment options, deciding on a dosage change) is based on interpreting data from an investigation (e.g. physiological measurement, blood test) be based on a list of 5 monitoring options relating to the treatment identified, from which the candidate will be required to select the most appropriate Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

39 Prescribing Skills Assessment DATA INTERPRETATION Good Data Interpretation question items should: contain sufficient information to allow a competent candidate to select the best option unambiguously contain 4 distracting options that, while plausible, are clearly less appropriate in relation to responding to the data than the correct answer. Question Select the most appropriate decision option with regard to [the xxxx prescription/the treatment of xxxxxx] based on these data. (mark it with a tick) Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

40 Prescribing Skills Assessment Data Interpretation Item DAT000 ID This question item is worth 2 marks You may use the BNF at any time DECISION OPTIONS AOption A ☐ BOption B ☐ COption C ☐ DOption D ☐ EOption E ☐ Case presentation A [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom that might be used as the focus for one of the questions] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility – the presentations should be fairly brief but identify the treatment for which a decision is required, the therapeutic indication and sufficient information about the patient to for the candidate to be able to identify the best decision option] Question Select the most appropriate decision option with regard to [the xxxx prescription/the treatment of xxxxxx] based on these data. (mark it with a tick) Answer box Option AJustification Write a brief justification in this box Option BJustification Write a brief justification in this box Option CJustification Option DJustification Option EJustification Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

41 Prescribing Skills Assessment DATA INTERPRETATION MANAGEMENT OPTIONS AOption A ☐ BOption B ☐ COption C ☐ DOption D ☐ EOption E ☐ List options in alphabetical order, starting with a lower case letter, unless option is a proper noun. Identify the correct answer by placing a tick in the column on the right. Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

42 Prescribing Skills Assessment DATA INTERPRETATION Answer box Option AJustification Write a brief justification in this box Option BJustification Write a brief justification in this box Option CJustification Option DJustification Option EJustification Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

43 Prescribing Skills Assessment StationDescriptionMarksNature of task 1Prescribing 110Suggest 1 drug 2Prescribing 210Suggest 1 drug 3Prescription Review 18Choose 1–3 options from 4–10 4Planning Management8Choose 2 options from 5 5Communicating Information6Choose 2 options from 5 6Drug Calculation Skills8Calculate 1 value 7Prescribing 310Suggest 1 drug 8Prescribing 410Suggest 1 drug 9Prescription Review 28Choose 1–3 options from 4–10 10Adverse Drug Reactions8Choose 2 options from 5 11Drug Monitoring8Choose 2 options from 5 12Data Interpretation6Choose 1 option from 5 TOTAL MARKS100 Prescribing Skills Assessment – Format Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

44 Prescribing Skills Assessment StationDescriptionMarksNature of task 1Prescribing 110Suggest 1 drug 2Prescribing 210Suggest 1 drug 3Prescription Review 18Choose 1–3 options from 4–10 4Planning Management8Choose 2 options from 5 5Communicating Information6Choose 2 options from 5 6Drug Calculation Skills8Calculate 1 value 7Prescribing 310Suggest 1 drug 8Prescribing 410Suggest 1 drug 9Prescription Review 28Choose 1–3 options from 4–10 10Adverse Drug Reactions8Choose 2 options from 5 11Drug Monitoring8Choose 2 options from 5 12Data Interpretation6Choose 1 option from 5 TOTAL MARKS100 Prescribing Skills Assessment – Format Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

45 Prescribing Skills Assessment ONE/TWO BEST ANSWER QUESTIONS  Identify the topic  Ensure it is important, and not trivial  Draw material from encounters with students who are not certain to pass, such as:  unexpected ignorance  misconceptions  errors of judgement  What precise knowledge do you wish to test?  Limit question to single testing point Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

46 Prescribing Skills Assessment ONE/TWO BEST ANSWER QUESTIONS  Write down the correct answer(s)  Identify three/four plausible alternative options that are:  incorrect/clearly less correct than agreed answer  not widely divergent  not worded as ‘all/none of the above’ Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.

47 Prescribing Skills Assessment ONE/TWO BEST ANSWER QUESTIONS  Build the stem as a fictional scenario that includes all the information necessary to choose the correct answer (and no more)  Check that:  stem is written economically  lead-in and options follow logically Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.


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